Collaborative management model combined with inhaled corticosteroids in CPAP treatment of acute exacerbations of pediatric bronchial asthma: A retrospective cohort study.

BACKGROUND

Continuous positive airway pressure (CPAP) for treating acute pediatric bronchial asthma exacerbations rises yearly. Inhaled corticosteroids (ICS) are key for controlling asthma-related inflammation, but research on ICS combined with the collaborative management model (CMM) remains incomplete.

OBJECTIVES

This study aims to explore the effect of CMM combined with ICS in CPAP treatment for children with acute bronchial asthma exacerbations.

METHODS

107 children with acute bronchial asthma exacerbations receiving CPAP in our hospital's Respiratory Department (Jan 2023-Jan 2025) were screened; 104 were included after exclusions. Based on the records of medical record treatment, they were divided into ICS group (51 cases) and CMM+ICS group (combined group, 53 cases).

PRIMARY OUTCOMES: pulmonary function [forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF)], arterial blood gas [Arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), oxygen saturation (SaO2)] and CPAP-related complication incidence.

SECONDARY OUTCOMES: vital signs [respiratory rate (RR), heart rate (HR), blood pressure (BP)], hospital stay length, duration of a single management session, incremental cost-effectiveness ratio (ICER), pediatric asthma quality of life questionnaire (PAQLQ) scores and parental self-rating anxiety scale (SAS) anxiety levels.

RESULTS

Results showed that the combined group had significantly higher FEV1, PEF, PaO2 and SaO2 than the ICS group (all p<0.05), whereas PaCO2 (p<0.001) and CPAP complication incidence (p=0.024) were lower than the ICS group. Additionally, the combined group had significantly lower RR, HR, SBP and DBP (all p<0.05), significantly shorter hospital stay and duration of a single management session (both p<0.001) and a significantly favorable ICER (-225.13 yuan/day) than the ICS group. Moreover, it had significantly higher PAQLQ scores (p<0.001) and lower parental SAS scores (p<0.001) compared with the ICS group.

CONCLUSION

CMM combined with ICS in CPAP improves pediatric acute asthma exacerbations, has high clinical value, worthy of respiratory promotion.